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Shuford KV, Turner HC, Anderson RM. Compliance with anthelmintic treatment in the neglected tropical diseases control programmes: a systematic review. Parasit Vectors 2016; 9:29. [PMID: 26813098 PMCID: PMC4729159 DOI: 10.1186/s13071-016-1311-1] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 01/11/2016] [Indexed: 12/27/2022] Open
Abstract
Preventive chemotherapy (PCT) programmes are used to control five of the highest burden neglected tropical diseases (NTDs): soil-transmitted helminth infections (hookworm, ascariasis, and trichuriasis), lymphatic filariasis, schistosomiasis, onchocerciasis, and trachoma. Over the past decade, new resource commitments for the NTDs have enabled such programmes to intensify their control efforts, and for some diseases, to shift from goals of morbidity control to the interruption of transmission and elimination. To successfully eliminate the parasite reservoir, these programmes will undoubtedly require prolonged, high treatment coverage. However, it is important to consider that even when coverage levels reach an acceptable proportion of the target population, there may be a considerable gap between coverage (those who receive the drug) and compliance (those who actually consume the drug)—a topic of fundamental and perhaps underestimated importance. We conducted a systematic review of published literature that investigated compliance to PCT programmes for NTD control and elimination. Databases searched included PubMed/Medline, Web of Knowledge (including Web of Science), OVID, and Scopus. Data were collected on compliance rates, reasons for non-compliance, as well as the heterogeneity of compliance definitions and calculations across programmes and studies. A total of 112 studies were selected for inclusion. The findings of the review revealed substantial heterogeneity across compliance terms and definitions; an imbalance of available studies for particular disease areas and countries; and finally, a lack of longitudinal compliance studies to properly investigate the role of systematic non-compliance. The lack of consistency among reporting of compliance data can result in under- or over-estimating compliance in a population, and therefore has serious implications for setting and reaching elimination targets. Reframing of the guidelines on compliance definitions coupled with an urgent call for longitudinal research in systematic non-compliance should be essential elements in the programmatic shift from control to elimination.
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Affiliation(s)
- Kathryn V Shuford
- London Centre for Neglected Tropical Disease Research, London, UK. .,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK.
| | - Hugo C Turner
- London Centre for Neglected Tropical Disease Research, London, UK. .,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK.
| | - Roy M Anderson
- London Centre for Neglected Tropical Disease Research, London, UK. .,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK.
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Dunn JC, Turner HC, Tun A, Anderson RM. Epidemiological surveys of, and research on, soil-transmitted helminths in Southeast Asia: a systematic review. Parasit Vectors 2016; 9:31. [PMID: 26813007 PMCID: PMC4728827 DOI: 10.1186/s13071-016-1310-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 01/08/2016] [Indexed: 11/10/2022] Open
Abstract
Soil-transmitted helminth (STH) infections of humans fall within the World Health Organization's (WHO) grouping termed the neglected tropical diseases (NTDs). It is estimated that they affect approximately 1.4 billion people worldwide. A significant proportion of these infections are in the population of Southeast Asia. This review analyses published data on STH prevalence and intensity in Southeast Asia over the time period of 1900 to the present to describe age related patterns in these epidemiological measures. This is with a focus on the four major parasite species affecting humans; namely Ascaris lumbricoides, Trichuris trichiura and the hookworms; Necator americanus and Ancylostoma duodenale. Data were also collected on the diagnostic methods used in the published surveys and how the studies were designed to facilitate comparative analyses of recorded patterns and changes therein over time. PubMed, Google Scholar, EMBASE, ISI Web of Science, Cochrane Database of Systematic Reviews and the Global Atlas of Helminth Infections search engines were used to identify studies on STH in Southeast Asia with the search based on the major key words, and variants on, "soil-transmitted helminth" "Ascaris" "Trichuris" "hookworm" and the country name. A total of 280 studies satisfied the inclusion criteria from 11 Southeast Asian countries; Brunei, Cambodia, Indonesia, Lao People's Democratic Republic (Lao PDR), Malaysia, Myanmar, Philippines, Singapore, Thailand, Timor-Leste and Vietnam. It was concluded that the epidemiological patterns of STH infection by age and species mix in Southeast Asia are similar to those reported in other parts of the world. In the published studies there were a large number of different diagnostic methods used with differing sensitivities and specificities, which makes comparison of the results both within and between countries difficult. There is a clear requirement to standardise the methods of both STH diagnosis in faecal material and how the intensity of infection is recorded and reported in future STH research and in monitoring and evaluation (M&E) of the impact of continuing and expanding mass drug administration (MDA) programmes.
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Affiliation(s)
- Julia C Dunn
- London Centre for Neglected Tropical Disease Research, London, UK. .,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, UK.
| | - Hugo C Turner
- London Centre for Neglected Tropical Disease Research, London, UK. .,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, UK.
| | - Aung Tun
- Worm Free Myanmar Kids Program, Tun Khit Foundation, Yangon, Myanmar.
| | - Roy M Anderson
- London Centre for Neglected Tropical Disease Research, London, UK. .,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, UK.
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Medley GF, Turner HC, Baggaley RF, Holland C, Hollingsworth TD. The Role of More Sensitive Helminth Diagnostics in Mass Drug Administration Campaigns: Elimination and Health Impacts. ADVANCES IN PARASITOLOGY 2016; 94:343-392. [PMID: 27756457 DOI: 10.1016/bs.apar.2016.08.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Diagnostics play a crucial role in determining treatment protocols and evaluating success of mass drug administration (MDA) programmes used to control soil-transmitted helminths (STHs). The current diagnostic, Kato-Katz, relies on inexpensive, reusable materials and can be used in the field, but only trained microscopists can read slides. This diagnostic always underestimates the true prevalence of infection, and the accuracy worsens as the true prevalence falls. We investigate how more sensitive diagnostics would impact on the management and life cycle of MDA programmes, including number of mass treatment rounds, health impact, number of unnecessary treatments and probability of elimination. We use an individual-based model of STH transmission within the current World Health Organization (WHO) treatment guidelines which records individual disability-adjusted life years (DALY) lost. We focus on Ascaris lumbricoides due to the availability of high-quality data on existing diagnostics. We show that the effect of improving the sensitivity of diagnostics is principally determined by the precontrol prevalence in the community. Communities at low true prevalence (<30%) and high true prevalence (>70%) do not benefit greatly from improved diagnostics. Communities with intermediate prevalence benefit greatly from increased chemotherapy application, both in terms of reduced DALY loss and increased probability of elimination. Our results suggest that programmes should be extended beyond school-age children, especially in high prevalence communities. Finally, we argue against using apparent or measured prevalence as an uncorrected proxy for true prevalence.
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Affiliation(s)
- G F Medley
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - H C Turner
- Imperial College London, London, United Kingdom
| | - R F Baggaley
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - C Holland
- Trinity College Dublin, Dublin, Ireland
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Anderson RM, Turner HC, Farrell SH, Truscott JE. Studies of the Transmission Dynamics, Mathematical Model Development and the Control of Schistosome Parasites by Mass Drug Administration in Human Communities. ADVANCES IN PARASITOLOGY 2016; 94:199-246. [PMID: 27756455 DOI: 10.1016/bs.apar.2016.06.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Schistosomiasis is global in extent within developing countries, but more than 90% of the at-risk population lives in sub-Saharan Africa. In total, 261 million people are estimated to require preventive treatment. However, with increasing drug availability through donation, the World Health Organization has set a goal of increasing coverage to 75% of at-risk children in endemic countries and elimination in some regions. In this chapter, we discuss key biological and epidemiological processes involved in the schistosome transmission cycle and review the history of modelling schistosomiasis and the impact of mass drug administration, including both deterministic and stochastic approaches. In particular, we look at the potential impact of the WHO 2020 schistosomiasis treatment goals.
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Affiliation(s)
- R M Anderson
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | - H C Turner
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | - S H Farrell
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | - J E Truscott
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
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Hollingsworth TD, Adams ER, Anderson RM, Atkins K, Bartsch S, Basáñez MG, Behrend M, Blok DJ, Chapman LAC, Coffeng L, Courtenay O, Crump RE, de Vlas SJ, Dobson A, Dyson L, Farkas H, Galvani AP, Gambhir M, Gurarie D, Irvine MA, Jervis S, Keeling MJ, Kelly-Hope L, King C, Lee BY, Le Rutte EA, Lietman TM, Ndeffo-Mbah M, Medley GF, Michael E, Pandey A, Peterson JK, Pinsent A, Porco TC, Richardus JH, Reimer L, Rock KS, Singh BK, Stolk W, Swaminathan S, Torr SJ, Townsend J, Truscott J, Walker M, Zoueva A. Quantitative analyses and modelling to support achievement of the 2020 goals for nine neglected tropical diseases. Parasit Vectors 2015; 8:630. [PMID: 26652272 PMCID: PMC4674954 DOI: 10.1186/s13071-015-1235-1] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 12/01/2015] [Indexed: 12/30/2022] Open
Abstract
Quantitative analysis and mathematical models are useful tools in informing strategies to control or eliminate disease. Currently, there is an urgent need to develop these tools to inform policy to achieve the 2020 goals for neglected tropical diseases (NTDs). In this paper we give an overview of a collection of novel model-based analyses which aim to address key questions on the dynamics of transmission and control of nine NTDs: Chagas disease, visceral leishmaniasis, human African trypanosomiasis, leprosy, soil-transmitted helminths, schistosomiasis, lymphatic filariasis, onchocerciasis and trachoma. Several common themes resonate throughout these analyses, including: the importance of epidemiological setting on the success of interventions; targeting groups who are at highest risk of infection or re-infection; and reaching populations who are not accessing interventions and may act as a reservoir for infection,. The results also highlight the challenge of maintaining elimination 'as a public health problem' when true elimination is not reached. The models elucidate the factors that may be contributing most to persistence of disease and discuss the requirements for eventually achieving true elimination, if that is possible. Overall this collection presents new analyses to inform current control initiatives. These papers form a base from which further development of the models and more rigorous validation against a variety of datasets can help to give more detailed advice. At the moment, the models' predictions are being considered as the world prepares for a final push towards control or elimination of neglected tropical diseases by 2020.
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Affiliation(s)
| | - Emily R Adams
- Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | | | - Katherine Atkins
- London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Sarah Bartsch
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | | | | | - David J Blok
- Erasmus University Medical Center, 3015 CE, Rotterdam, Netherlands
| | | | - Luc Coffeng
- Erasmus University Medical Center, 3015 CE, Rotterdam, Netherlands
| | | | - Ron E Crump
- University of Warwick, Coventry, CV4 7AL, UK
| | - Sake J de Vlas
- Erasmus University Medical Center, 3015 CE, Rotterdam, Netherlands
| | - Andy Dobson
- Princeton University, New Jersey, NJ, 08544, USA
| | | | | | | | | | - David Gurarie
- Case Western Reserve University, Cleveland, OH, 44106, USA
| | | | | | | | | | - Charles King
- Case Western Reserve University, Cleveland, OH, 44106, USA
| | - Bruce Y Lee
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Epke A Le Rutte
- Erasmus University Medical Center, 3015 CE, Rotterdam, Netherlands
| | - Thomas M Lietman
- University of California, San Francisco, San Francisco, CA, 94143, USA
| | | | - Graham F Medley
- London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Edwin Michael
- University of Notre Dame, South Bend, IN, 47556, USA
| | | | | | - Amy Pinsent
- Monash University, Melbourne, VIC, 3800, Australia
| | - Travis C Porco
- University of California, San Francisco, San Francisco, CA, 94143, USA
| | | | - Lisa Reimer
- Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Kat S Rock
- University of Warwick, Coventry, CV4 7AL, UK
| | | | - Wilma Stolk
- Erasmus University Medical Center, 3015 CE, Rotterdam, Netherlands
| | | | - Steve J Torr
- Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
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Turner HC, Truscott JE, Bettis AA, Shuford KV, Dunn JC, Hollingsworth TD, Brooker SJ, Anderson RM. An economic evaluation of expanding hookworm control strategies to target the whole community. Parasit Vectors 2015; 8:570. [PMID: 26542226 PMCID: PMC4635541 DOI: 10.1186/s13071-015-1187-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 10/23/2015] [Indexed: 11/10/2022] Open
Abstract
Background The WHO treatment guidelines for the soil-transmitted helminths (STH) focus on targeting children for the control of morbidity induced by heavy infections. However, unlike the other STHs, the majority of hookworm infections are harboured by adults. This untreated burden may have important implications for controlling both hookworm’s morbidity and transmission. This is particularly significant in the context of the increased interest in investigating STH elimination strategies. Methods We used a deterministic STH transmission model and parameter estimates derived from field epidemiological studies to evaluate the impact of child-targeted (2–14 year olds) versus community-wide treatment against hookworm in terms of preventing morbidity and the timeframe for breaking transmission. Furthermore, we investigated how mass treatment may influence the long-term programmatic costs of preventive chemotherapy for hookworm. Results The model projected that a large proportion of the overall morbidity due to hookworm was unaffected by the current child-targeted strategy. Furthermore, driving worm burdens to levels low enough to potentially break transmission was only possible when using community-wide treatment. Due to these projected reductions in programme duration, it was possible for community-wide treatment to generate cost savings – even if it notably increases the annual distribution costs. Conclusions Community-wide treatment is notably more cost-effective for controlling hookworm’s morbidity and transmission than the current child-targeted strategies and could even be cost-saving in many settings in the longer term. These calculations suggest that it is not optimum to treat using the same treatment strategies as other STH. Hookworm morbidity and transmission control require community-wide treatment. Electronic supplementary material The online version of this article (doi:10.1186/s13071-015-1187-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hugo C Turner
- London Centre for Neglected Tropical Disease Research, London, UK. .,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK.
| | - James E Truscott
- London Centre for Neglected Tropical Disease Research, London, UK. .,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK.
| | - Alison A Bettis
- London Centre for Neglected Tropical Disease Research, London, UK. .,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK.
| | - Kathryn V Shuford
- London Centre for Neglected Tropical Disease Research, London, UK. .,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK.
| | - Julia C Dunn
- London Centre for Neglected Tropical Disease Research, London, UK. .,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK.
| | - T Déirdre Hollingsworth
- Mathematics Institute, University of Warwick, Coventry, CV4 7AL, UK. .,School of Life Sciences, University of Warwick, Coventry, CV4 7AL, UK.
| | - Simon J Brooker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - Roy M Anderson
- London Centre for Neglected Tropical Disease Research, London, UK. .,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK.
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Feasibility of controlling hookworm infection through preventive chemotherapy: a simulation study using the individual-based WORMSIM modelling framework. Parasit Vectors 2015; 8:541. [PMID: 26489659 PMCID: PMC4618856 DOI: 10.1186/s13071-015-1151-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Accepted: 10/07/2015] [Indexed: 12/31/2022] Open
Abstract
Background Globally, hookworms infect 440 million people in developing countries. Especially children and women of childbearing age are at risk of developing anaemia as a result of infection. To control hookworm infection and disease (i.e. reduce the prevalence of medium and heavy infection to <1 %), the World Health Organization has set the target to provide annual or semi-annual preventive chemotherapy (PC) with albendazole (ALB) or mebendazole (MEB) to at least 75 % of all children and women of childbearing age in endemic areas by 2020. Here, we predict the feasibility of achieving <1 % prevalence of medium and heavy infection, based on simulations with an individual-based model. Methods We developed WORMSIM, a new generalized individual-based modelling framework for transmission and control of helminths, and quantified it for hookworm transmission based on published data. We simulated the impact of standard and more intense PC strategies on trends in hookworm infection, and explored the potential additional impact of interventions that improve access to water, sanitation, and hygiene (WASH). The individual-based framework allowed us to take account of inter-individual heterogeneities in exposure and contribution to transmission of infection, as well as in participation in successive PC rounds. Results We predict that in low and medium endemic areas, current PC strategies (including targeting of WCBA) will achieve control of hookworm infection (i.e. the parasitological target) within 2 years. In highly endemic areas, control can be achieved with semi-annual PC with ALB at 90 % coverage, combined with interventions that reduce host contributions to the environmental reservoir of infection by 50 %. More intense PC strategies (high frequency and coverage) can help speed up control of hookworm infection, and may be necessary in some extremely highly endemic settings, but are not a panacea against systematic non-participation to PC. Conclusions Control of hookworm infection by 2020 is feasible with current PC strategies (including targeting of WCBA). In highly endemic areas, PC should be combined with health education and/or WASH interventions. Electronic supplementary material The online version of this article (doi:10.1186/s13071-015-1151-4) contains supplementary material, which is available to authorized users.
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